Individual provider Active NPI

Steven Eugene Dale, PT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1477632412
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00000697 Issued in WA
Practice address
307 S 12TH Ave Ste 5
Yakima, WA 98902-3139
Phone
(509) 453-3103
Fax
(509) 453-2057
NPI assigned
Nov 2, 2006
Last updated
May 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00000697 WA Primary

Addresses

Primary practice location

307 S 12TH Ave Ste 5
Yakima, WA 98902-3139

Mailing address

307 S 12TH Ave Ste 5
Yakima, WA 98902-3139
Phone (509) 453-3103

Other identifiers 5

IdentifierTypeStateIssuer
4496OtherWAGROUP HEALTH
79292OtherWALABOR & INDUSTRY
1477632412MedicaidWA
8335952MedicaidWA
0258827OtherWAWASHINGTON L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00000697WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Medical Center Physical Therapy & Sports Rehab Inc PS Physical Therapist PastSince Jun 1, 1980 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1477632412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 5",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023139",
            "telephone_number": "509-453-3103",
            "fax_number": "509-453-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 5",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023139",
            "telephone_number": "509-453-3103",
            "fax_number": "509-453-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "STEVEN",
        "middle_name": "EUGENE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "4496",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "79292",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477632412",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335952",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L&I",
            "identifier": "0258827",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.